WO2019236899A1 - Circuit de ventilateur pour nébuliseurs actionnés par la respiration - Google Patents

Circuit de ventilateur pour nébuliseurs actionnés par la respiration Download PDF

Info

Publication number
WO2019236899A1
WO2019236899A1 PCT/US2019/035860 US2019035860W WO2019236899A1 WO 2019236899 A1 WO2019236899 A1 WO 2019236899A1 US 2019035860 W US2019035860 W US 2019035860W WO 2019236899 A1 WO2019236899 A1 WO 2019236899A1
Authority
WO
WIPO (PCT)
Prior art keywords
nebulizer
inspiratory
ventilator
patient
way valve
Prior art date
Application number
PCT/US2019/035860
Other languages
English (en)
Inventor
Gerald Smaldone
Original Assignee
The Research Foundation For The State University Of New York
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The Research Foundation For The State University Of New York filed Critical The Research Foundation For The State University Of New York
Priority to CA3102421A priority Critical patent/CA3102421A1/fr
Priority to MX2020013255A priority patent/MX2020013255A/es
Priority to EP19816173.9A priority patent/EP3801715A4/fr
Priority to KR1020207036504A priority patent/KR20210018306A/ko
Priority to US15/734,677 priority patent/US20210236750A1/en
Publication of WO2019236899A1 publication Critical patent/WO2019236899A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M11/00—Sprayers or atomisers specially adapted for therapeutic purposes
    • A61M11/06—Sprayers or atomisers specially adapted for therapeutic purposes of the injector type
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M15/00—Inhalators
    • A61M15/0091—Inhalators mechanically breath-triggered
    • A61M15/0095—Preventing manual activation in absence of inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M15/00—Inhalators
    • A61M15/0091—Inhalators mechanically breath-triggered
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M11/00—Sprayers or atomisers specially adapted for therapeutic purposes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M15/00—Inhalators
    • A61M15/0001—Details of inhalators; Constructional features thereof
    • A61M15/0005—Details of inhalators; Constructional features thereof with means for agitating the medicament
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M15/00—Inhalators
    • A61M15/0001—Details of inhalators; Constructional features thereof
    • A61M15/002—Details of inhalators; Constructional features thereof with air flow regulating means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M15/00—Inhalators
    • A61M15/0086—Inhalation chambers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M15/00—Inhalators
    • A61M15/0091—Inhalators mechanically breath-triggered
    • A61M15/0098—Activated by exhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0463—Tracheal tubes combined with suction tubes, catheters or the like; Outside connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0883—Circuit type
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/12—Preparation of respiratory gases or vapours by mixing different gases
    • A61M16/122—Preparation of respiratory gases or vapours by mixing different gases with dilution
    • A61M16/125—Diluting primary gas with ambient air
    • A61M16/127—Diluting primary gas with ambient air by Venturi effect, i.e. entrainment mixers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816—Joints or connectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0875—Connecting tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
    • A61M16/147—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase the respiratory gas not passing through the liquid container
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
    • A61M16/16—Devices to humidify the respiration air
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3331—Pressure; Flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2206/00—Characteristics of a physical parameter; associated device therefor
    • A61M2206/10—Flow characteristics
    • A61M2206/20—Flow characteristics having means for promoting or enhancing the flow, actively or passively

Definitions

  • This invention pertains to the administration of nebulized drugs to patients connected to a mechanical ventilator breathing circuit.
  • nebulized drugs to patients on a mechanical ventilator
  • Challenges in the administration of nebulized drugs to patients on a mechanical ventilator include maximizing efficient delivery of the drug to the lungs of the patient and provision of properly humidified breathing gases.
  • Inefficient drug delivery wastes drug product, which may be expensive, may cause unpredictable dosing to patients (too much or too little drug), and may cause undesirable exposure of drug to surrounding persons.
  • the term“nebulized” is also referred to as“atomized” or“aerosolized,” and all three terms are interchangeable.
  • drug as used herein is interchangeable with
  • Ventilation circuits have previously been described in, e.g., US 2014/0238397 A1 , published Aug. 24, 2014, and US 2015/0108670 A1 , published Apr. 23, 2015.
  • the present invention describes a novel ventilator circuit that minimizes the influences of duty cycle or the inhalation-exhalation (l/E) ratio, bias flow, and humidification by utilizing a design that results in aerosol generation primarily during inspiration (breath enhancement) and minimizes expiratory losses (breath-actuation).
  • the circuit facilitates control of supplemental humidification and functions independently of the brand of the ventilator.
  • the instant invention is designed to provide the benefits of dry nebulization, humidification as required, and isolation of the nebulizer for efficient removal without interrupting the breathing.
  • a ventilator circuit apparatus for the administration of nebulized drugs through an endotracheal tube to a patient on a mechanical ventilator that controls breathing gases to the patient.
  • the apparatus has a breathing circuit with an inspiratory limb and exhalation limb connected to the ventilator; a nebulizer on the inspiratory limb interposed between a T-fitting and a three-way valve such that the nebulizer can be removed from the inspiratory limb without interrupting the flow of breathing gases to the patient; and a humidifier or heat and moisture exchanger (HME) on the inspiratory limb interposed between the nebulizer and the endotracheal tube.
  • HME heat and moisture exchanger
  • the nebulizer is a jet-nebulizer.
  • the nebulizer is breath- actuated, further comprising a pressure sensor interposed between the nebulizer and the ventilator, wherein the pressure sensor controls a pressurized air supply to the nebulizer required for nebulization to occur, such that nebulization only occurs during a pressure increase on the inspiratory limb caused by an increase in air pressure from the ventilator to force an inhalation by the patient.
  • the nebulizer is breath-enhanced.
  • a ventilator circuit apparatus for the administration of nebulized drugs through an endotracheal tube to a patient on a mechanical ventilator that provides breathing gases for inhalation by the patient.
  • the apparatus has an inspiratory tube connected to an endotracheal tube intubated into a patient; a ventilator circuit comprising a T-fitting with three connections, wherein a first connection to the T-fitting is connected to the inspiratory tube, wherein a second connection of the T-fitting is connected to the output port of a humidifier, and wherein a third connection of the T-fitting is connected to the output port of a nebulizer; wherein the input port of the nebulizer is connected to a three-way valve, and wherein a second connection of the three-way valve is connected to the input port of the humidifier, and wherein a third connection of the three-way valve is connected to an inspiratory output of the mechanical ventilator; wherein in a first position
  • a temperature sensor is provided on in the inspiratory tube that controls the amount of water vapor produced by the humidifier.
  • one or two connections to the T-fitting have a spring-loaded self sealing fitting, permitting a tube inserted in the connection to be pulled out, whereupon the connection to self-seals.
  • a ventilator circuit apparatus for the administration of nebulized drugs through an endotracheal tube to a patient on a mechanical ventilator that provides breathing gases for inhalation by the patient.
  • the apparatus has an inspiratory tube in fluid communication with an endotracheal tube intubated into a patient; a ventilator circuit comprising a T-fitting with three connections, wherein a first connection to the T-fitting is connected to the inspiratory tube, wherein a second connection of the T-fitting is connected to a three-way valve, and wherein a third connection of the T-fitting is connected to the output port of a nebulizer; wherein the input port of the nebulizer is connected to the three- way valve, and wherein a third connection of the three-way valve is connected to an inspiratory output of the mechanical ventilator; wherein in a first position of the three-way valve, the circuit is open that bypasses the nebulizer and directly connects
  • a heat and moisture exchanger (HME) with a bypass mode is on the inspiratory tube such that when the three-way valve is in the first position, the HME delivers humidified breathing gases to the patient, and when the three-way valve is in the second position, the HME is switched to bypass mode.
  • HME heat and moisture exchanger
  • the ventilator circuit apparatus for the administration of nebulized drugs through an endotracheal tube to a patient on a mechanical ventilator that provides breathing gases for inhalation by the patient.
  • the apparatus has an inspiratory tube connected to an endotracheal tube intubated into a patient; a ventilator circuit comprising a T-fitting with three connections, wherein a first connection to the T- fitting is connected to the inspiratory tube, wherein a second connection of the T-fitting is connected by a tube to a first connection on a three-way valve, and wherein a third connection of the T-fitting is connected to the output port of a nebulizer; wherein the input port of the nebulizer is connected to a second connection of the three-way valve, and wherein a third connection of the three-way valve is connected to an inspiratory output of the mechanical ventilator; wherein in a first position of the three-way valve, the circuit is open that bypasses the
  • a ball-valve is interposed between the T-fitting and the nebulizer. In an embodiment, a ball-valve is interposed between the T-fitting and the nebulizer, and when the three-way valve is in position one and the ball valve is closed, the nebulizer can be removed from the ventilator circuit without interrupting the flow of breathing gases to the patient.
  • a temperature sensor is provided on in the inspiratory tube that controls the amount of water vapor produced by the humidifier.
  • the apparatus has an HME.
  • a method is provided of administering a nebulized drug with any of the apparatus embodiments of this invention.
  • the present invention uses breath-enhanced nebulizers.
  • the nebulization may be breath-activated.
  • Prior art breath-enhanced nebulizers have only been used with spontaneously breathing patients.
  • Using a breath- enhanced nebulizer with a mechanical ventilator and a breathing circuit allows further enhances the patient’s berating and facilitates the desired drug intake.
  • breath-enhanced nebulizers such as those disclosed in this invention, can significantly increase the fraction of drug that is inhaled by the patient and delivered to the lungs (as measured by an inhaled mass (IM) filter in a test apparatus).
  • IM inhaled mass
  • the BEN can significantly shorten the time required to nebulize a particular dose of medication., which can be a significant advantage to the care facility.
  • FIG. 1 shows an embodiment of a ventilator circuit of this invention with the inhaled air flow directed to a nebulizer.
  • FIG. 2 is a schematic view of the embodiment of the ventilator circuit of Fig. 1 , but with the inhaled air flow bypassing the nebulizer and directed through a humidifier.
  • FIG. 3 is a schematic view of an embodiment of a ventilator circuit with the inhaled airflow directed to the nebulizer and passing through a heat and moisture exchanger (HME).
  • HME heat and moisture exchanger
  • Fig. 4 is a schematic view of the embodiment of the ventilator circuit of Fig. 3 with the inhaled air flow bypassing the nebulizer and passing through an HME.
  • Fig. 5 is a schematic view of an embodiment of a ventilator circuit with a T-fitting and a ball valve.
  • Fig. 6 is a schematic view of a portion of the ventilator circuit of Fig. 5 showing the air flowing through the nebulizer and the ball valve during inhalation while the nebulized drug is being provided by the nebulizer.
  • Fig. 7 is a schematic view of a portion of the ventilator circuit of Fig. 5 showing the air flow bypassing nebulizer and passing through the humidifier.
  • Fig. 8 s a schematic view of a portion of the ventilator circuit of Fig. 5 showing the three-way valve and ball valve configured so that the nebulizer is isolated from the circuit and can be removed without interrupting the circuit.
  • Fig. 9 is a schematic view of the ventilator circuit of Fig. 5 without a humidifier showing the air flow during inhalation.
  • An HME would be used in this embodiment.
  • a breathing circuit for the administration of nebulized drugs to a patient breathing with the aid of a mechanical ventilator and a breathing circuit.
  • part of the circuit is a nebulizer, which nebulizes a drug solution for inhalation of the drug by a patient.
  • the nebulizer is a jet nebulizer that nebulizes drug solutions by shear forces from a compressed air supply to the nebulizer jet.
  • the nebulizer is another type of nebulizer, for example, a vibrating mesh nebulizer or an ultrasonic nebulizer.
  • a three-way valve may be included that has two operating positions.
  • a second position directs all ventilator flow to the nebulizer resulting in an aerosol generation, which may be limited to nebulization during the inhalation portion of a breathing cycle only.
  • the breathing gases from the ventilator bypass the ventilator and pass instead either directly to the inspiratory limb of the breathing circuit, or pass to the inspiratory limb through a humidifier.
  • special connections in the ventilator circuit bypass the nebulizer and allow for nebulizer removal for servicing without breaking the air flow in the circuit or interrupting breathing to the patient.
  • the nebulizer used in this invention is a jet-nebulizer and generates aerosol by nebulization only when a nebulizer air flow is provided.
  • An exemplary nebulizer is that disclosed in co-pending patent application [ ], filed [ ], and based on U.S. Provisional Patent Application No. 62/681 ,654 filed June 6, 2018. As disclosed therein, breath-enhanced and breath-actuated nebulizers are provided.
  • Breath-enhanced nebulizers have an internal configuration that enhances, or amplifies, the rate of nebulization compared to prior art jet nebulizers.
  • Embodiments of breath-enhanced nebulizers are disclosed in co-pending patent application [ ], based on U.S. Provisional Patent Application No. 62/681 ,654.
  • Other types of nebulizers may also be useful in this invention, including other jet nebulizer designs, vibrating mesh, and ultrasonic nebulizers that can be used in a breathing circuit controlled by a mechanical ventilator.
  • the nebulization is breath actuated.
  • breath actuated nebulizer compressed air is only provided to the nebulizer while the patient is inhaling. This is controlled with a pressure sensor that toggles the nebulizer air flow on or off as required.
  • the inhalation portion of a breathing cycle is also termed the "duty cycle," the fraction of time of an overall inhalation/exhalation cycle when the patient is actually inhaling.
  • breath-actuation relies on a pressure sensor that can detect when a patient is inhaling, as opposed to exhaling or neither inhaling nor exhaling, and the sensor can activate a solenoid that provides compressed air to the nebulizer.
  • the pressure sensor is placed on a tube in fluid communication with the inspiratory outlet of the mechanical ventilator.
  • the pressure sensor detects this increase and switches on a nebulizer air flow to the nebulizer, which drives the jet nebulizer and causes nebulization to occur.
  • Other means of toggling nebulization are possible with other types of nebulizers.
  • a pressure sensor can control the power supply that drives the nebulization.
  • the nebulized drug is provided by the inventive breathing circuits in such a way the humidification is not used during nebulization.
  • This may be a desirable feature based on previous studies (O’Riordan, Diot, and Miller, cited above) suggesting much lower nebulizer efficiency if a humidifier is placed before the nebulizer, so that humidified air or other breathing gases enter the nebulizer.
  • the term“breathing gases” means either ordinary air or another breathing gas mixture indicated for use in mechanical ventilation, such as oxygen enriched air.
  • the entire mass of breathing gases in the inspiratory tract passes through the nebulizer when the nebulizer is active.
  • a ventilator circuit apparatus 100 for the administration of nebulized drugs through an endotracheal tube to a patient on a mechanical ventilator 102 that controls breathing gases to the patient.
  • the apparatus has a breathing circuit with an inspiratory limb 107 and exhalation limb 119 connected to the ventilator 102; a nebulizer 101 on the inspiratory limb interposed between a T-fitting and a three-way valve such that the nebulizer can be removed from the inspiratory limb without interrupting the flow of breathing gases to the patient; and a humidifier 121 or heat and moisture exchanger (HME) (125, Figs. 3-5) on the inspiratory limb interposed between the nebulizer and the breathing tube 108, which in turn is in fluid communication with the endotracheal tube intubated in a patient.
  • HME heat and moisture exchanger
  • all breathing gases to the patient flow through the ventilator circuit.
  • an endotracheal tube would be used by a patient on a ventilator circuit such as disclosed in Figs. 1-9.
  • the breathing tube 108 would connect to the endotracheal tube.
  • a simulated lung 110 may be used, and various measurement devices (111 and 112) may be used (discussed below).
  • An expiratory line (limb) 119 is also attached to the breathing tube 108 through Y-connector 127 conducting the exhaled air to the ventilator expiratory input port 104.
  • nebulizer 101 produces an aerosol (when active) that is shunted through a T-fitting 106 to the inspiratory line 107 and the endotracheal tube 108 positioned downstream of the inspiratory line 107 where it is inhaled by the patient 110.
  • the nebulizer 101 is breath-actuated, further comprising a pressure sensor 114 interposed between the nebulizer 101 and the ventilator 102 wherein the pressure sensor controls a pressurized air supply 117 to the nebulizer required for nebulization to occur, such that nebulization only occurs during a pressure increase on the inspiratory limb caused by an increase in air pressure from the ventilator to force an inhalation by the patient.
  • pressure sensor 114 is in electronic communication with solenoid valve 116 via electrical connection 115 that toggles the supply of compressed air 117 on and off.
  • pressure sensor 114 activates solenoid 116 to toggle on, supplying compressed air 117 to nebulizer 101 via nebulizer air supply line 118, which causes nebulization to start.
  • pressure sensor 114 detects that the inhalation phase has stopped, and solenoid valve 116 toggles off stopping the compressed air to nebulizer 101 , which stops nebulization. Nebulization will not take place with jet nebulizer 101 unless air supply line 118 is active.
  • nebulizer compressed air 117 typically at 50 psig is used to drive the jet.
  • the nebulizer is breath-enhanced, which is discussed above.
  • humidifier 121 supplies properly humidified breathing gases to the patient, ideally at 100% humidity and 37°C at Y-connector 127. Regulation of the amount of humidity in the circuit is important. With too much humidity, water will tend to condense inside the circuit which is undesirable. With too little humidity, the patient will be uncomfortable and secretions can increase.
  • the humidity may be controlled, at least in part, by temperature sensor 128 in Y-connector 127, that is linked to the humidifier by wire 129.
  • inspiratory limb 107 may include internal heating elements to heat the breathing gases to an appropriate temperature.
  • a heat and moisture exchanger (HME) 125 may be employed instead of a humidifier. This is illustrated in Figs. 3 and 4.
  • the HME is a device capable of recycling moisture from the expiratory air from a patient.
  • the HME has a bypass mode, in which the humidification feature is turned off and the breathing gases simply pass through. This is necessary when the
  • nebulization is active.
  • the HME When the nebulizer is active, as shown in Fig. 3, the HME would be in bypass mode, since nebulized drug cannot pass through the internal membranes in an HME.
  • the HME would be active in the gas flow configuration shown in Fig. 4, where the nebulizer is bypassed, to provide humidified breathing gases to the patient.
  • This may be a default mode of operation since the time when a nebulizer is being used (i.e. , as shown in Fig. 3) may only be for one or two hours per day.
  • the three-way valve 105 In the operation of the three-way valve 105, during the inhalation phase of a breathing cycle, breathing gases from the mechanical ventilator inspiratory output port 103 are directed to the three-way valve with a stopcock 105. As shown in Figs. 1 -4, the three-way valve 105 has two modes. In the first mode (termed herein the first position), the three-way valve 105 is configured so that the breathing gases bypass the nebulizer and are shunted through the humidifier 121 (Fig. 2), or directly to an HME 125 in the active mode (Fig. 4). In the other mode of valve 105 (termed herein the second position), the breathing gases are shunted to nebulizer 101 as shown in Figs. 1 and 3. Nebulization may occur at this stage either in breath-actuated mode or continuous nebulization mode.
  • a closed system suction device 128, may be attached to the breathing tube 108 to allow the removal of secretions from the upper respiratory tract without having to open the ventilation circuit.
  • an inhaled mass filter (IM filter) 111 and a Cascade impactor 112 attached to the breathing tube 108 can be used to measure the dose of drug delivered to the patient (Fig. 1 ).
  • a vacuum pump 113 can be attached to the cascade impactor 112.
  • the inhaled mass filter traps nebulized particles where they can be measured either by weight or by e.g., scintillation counting for radiolabeled nebulized material.
  • a cascade impactor measures the droplet size of the aerosol just before reaching the simulated patient. In clinical practice, the IM filter and cascade impactor would not be used.
  • Fig. 2 shows the same apparatus as provided in Fig. 1 , but with the three-way valve 105 in the first position, bypassing the nebulizer 101.
  • the inspiratory airflow passes through humidifier 121 via humidifier inlet 122 and outlet 123.
  • the airflow path moves through a T-fitting 106 to the inspiratory line 107 and the breathing tube 108 where it is inhaled by the patient.
  • the T-fitting has one or two spring-loaded self-sealing fittings.
  • Such fittings include an internal mechanism opening the airway when a tube is inserted into the fitting. When the tube is removed, a valve closes from the force of a spring, sealing the opening.
  • a spring-loaded self-sealing fitting 132 is positioned at the T-fitting connection attached to the nebulizer.
  • another spring-loaded self-sealing fitting 124 is used at the T-fitting connection attached to the humidifier.
  • the attachment to the T-fitting 106 can be removed by separating the two parts, or pulling the connection off the T-fitting, whereupon the T-fitting branch self-seals.
  • This arrangement allows for the removal of the nebulizer or humidifier for (but not both) without interruption to the breathing of the patient. Removal of the nebulizer is most important and may be necessary on a routine basis to replenish the drug solution in the nebulizer.
  • the self-sealing T-fitting can play a critical role in the overall operation of the ventilator circuit embodiments as described herein. It is necessary to periodically remove the nebulizer from the ventilator circuit, for example, to replace it, to clean it, or to refill it. At the same time, a patient on mechanical ventilation is depending on the ventilator and the associated apparatus for their air for their lungs, which ideally is not interrupted, even for a few seconds. Accordingly, disassembling a ventilator circuit can be a problem. Removing a fitting to replace a routine must be done as quickly as possible. By the use of the spring- loaded T-fitting as described here, the nebulizer can be removed from the circuit very easily, with no interruption of air flow, and no break in the ventilator circuit.
  • FIG. 5-9 An alternative embodiment of the ventilator circuit is shown in Figs. 5-9, with a different configuration of the humidifier, T-fitting, and three-way valve.
  • self-sealing connections on the T-fitting are not used. Rather, a ball valve 126 positioned at the exit port of the nebulizer 101 is used instead.
  • the nebulization is active.
  • the T-fitting is directing the breathing gas flow to the nebulizer, and nebulization can take place when the nebulizer air flow in tube 118 is active.
  • the Ball valve 126 is in the open position and allows breathing gases and nebulized drug to flow from the nebulizer to the inspiratory limb 107, effectively bypassing the humidifier 121.
  • Fig. 7 shows the embodiment of Fig. 5 with the nebulizer bypassed.
  • Three-way valve 105 is in the first position in Fig. 7, directing the breathing gas flow through conduit 131 to humidifier 121.
  • the breathing gas flow exits the humidifier and passes through T- fitting 106 to inspiratory limb 107 and on the patient.
  • ball valve 126 is open, there is no circuit through nebulizer 101 , so it is effectively bypassed.
  • Fig. 8 shows the embodiment of Fig. 5 wherein the nebulizer is isolated for removal.
  • Three-way valve 105 is in the same position as in Fig. 7, directing the breathing gas to humidifier 121, and then to inspiratory limb 107 where the breathing gas goes to the patient.
  • ball valve 126 is in the off position and marked 126’, which isolates the nebulizer totally from the circuit.
  • the nebulizer is depicted as 101’, in broken lines, indicated it can be safely removed without interrupting the breathing gas circuit.
  • Fig. 9 is a portion of a circuit of an embodiment similar to Fig. 5, but with no humidifier.
  • humidification would be provided with an HME (not shown).
  • HME not shown
  • the three-way valve is in the second position, shunting the breathing gases to the nebulizer.
  • the breathing gases and atomized drug are depicted by the arrows entering inspiratory limb 107, where they would be directed to the patient.
  • the three-way valve is in the first position, the breathing gases would flow through conduit 131 bypassing the nebulizer.
  • the ball valve can also be turned off, as in Fig. 8, to isolate the nebulizer and allow it to be removed without interrupting the breathing gas circuit.

Abstract

L'invention concerne un appareil de circuit de ventilateur pour l'administration d'un médicament en aérosol à partir d'un nébuliseur par l'intermédiaire d'un tube endotrachéal à un patient sur un ventilateur mécanique, les gaz respiratoires étant humidifiés. Un moyen pour déconnecter le nébuliseur sans interrompre le flux d'air vers le patient est utilisé, présentant un raccord en T et une soupape à trois voies dans le circuit de ventilateur, qui permet au nébuliseur d'être contourné par le flux d'air, permettant au nébuliseur d'être enlevé de l'appareil sans interrompre le flux de gaz respiratoires vers le patient. Dans un mode de réalisation, le nébuliseur est un nébuliseur à jet amplifié par la respiration. Dans un mode de réalisation, le nébuliseur à jet est actionné par la respiration, par l'utilisation d'un capteur de pression d'air qui fait basculer le flux d'air sous pression vers le nébuliseur qui entraîne le jet requis pour la nébulisation.
PCT/US2019/035860 2018-06-06 2019-06-06 Circuit de ventilateur pour nébuliseurs actionnés par la respiration WO2019236899A1 (fr)

Priority Applications (5)

Application Number Priority Date Filing Date Title
CA3102421A CA3102421A1 (fr) 2018-06-06 2019-06-06 Nebuliseur actionne par le souffle pour un circuit de respirateur
MX2020013255A MX2020013255A (es) 2018-06-06 2019-06-06 Circuito de ventilacion para nebulizadores accionados por la respiracion.
EP19816173.9A EP3801715A4 (fr) 2018-06-06 2019-06-06 Circuit de ventilateur pour nébuliseurs actionnés par la respiration
KR1020207036504A KR20210018306A (ko) 2018-06-06 2019-06-06 인공호흡기 회로를 위한 호흡 작동식 네뷸라이저
US15/734,677 US20210236750A1 (en) 2018-06-06 2019-06-06 Breath actuated nebulizer for ventilator circuit

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201862681654P 2018-06-06 2018-06-06
US62/681,654 2018-06-06

Publications (1)

Publication Number Publication Date
WO2019236899A1 true WO2019236899A1 (fr) 2019-12-12

Family

ID=67070912

Family Applications (2)

Application Number Title Priority Date Filing Date
PCT/US2019/035856 WO2019236896A1 (fr) 2018-06-06 2019-06-06 Nébuliseur amélioré par la respiration pour l'administration de médicaments en aérosol à des patients ventilés
PCT/US2019/035860 WO2019236899A1 (fr) 2018-06-06 2019-06-06 Circuit de ventilateur pour nébuliseurs actionnés par la respiration

Family Applications Before (1)

Application Number Title Priority Date Filing Date
PCT/US2019/035856 WO2019236896A1 (fr) 2018-06-06 2019-06-06 Nébuliseur amélioré par la respiration pour l'administration de médicaments en aérosol à des patients ventilés

Country Status (6)

Country Link
US (2) US20210236750A1 (fr)
EP (2) EP3810235B1 (fr)
KR (2) KR20210049719A (fr)
CA (2) CA3102421A1 (fr)
MX (2) MX2020013255A (fr)
WO (2) WO2019236896A1 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022140800A1 (fr) * 2020-12-24 2022-06-30 The Research Foundation For The State University Of New York Circuit respiratoire de ventilateur avec un nébuliseur entre le ventilateur et l'humidificateur
US11497867B2 (en) 2016-12-09 2022-11-15 Trudell Medical International Smart nebulizer
US11666801B2 (en) 2018-01-04 2023-06-06 Trudell Medical International Smart oscillating positive expiratory pressure device
US11712175B2 (en) 2019-08-27 2023-08-01 Trudell Medical International Smart oscillating positive expiratory pressure device with feedback indicia
US11839716B2 (en) 2016-07-08 2023-12-12 Trudell Medical International Smart oscillating positive expiratory pressure device
US11964185B2 (en) 2023-04-24 2024-04-23 Trudell Medical International Smart oscillating positive expiratory pressure device

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019236896A1 (fr) 2018-06-06 2019-12-12 The Research Foundation For The State University Of New York Nébuliseur amélioré par la respiration pour l'administration de médicaments en aérosol à des patients ventilés
CN112156291B (zh) * 2020-08-05 2022-12-13 湖南人文科技学院 口吸式雾化器
CN112043927A (zh) * 2020-09-29 2020-12-08 重庆市第四人民医院 一种内科临床用呼吸装置
KR102364175B1 (ko) 2021-04-26 2022-02-18 엔텍메디칼(주) 인공호흡기용 약물 에어로졸 공급 장치
CN113713219B (zh) * 2021-07-28 2023-06-20 青岛市市立医院(青岛市临床医学研究所、青岛市医学影像中心) 一种临床呼吸困难监测判断用药一体化设备及其工作方法
CN114392432B (zh) * 2022-02-22 2022-12-16 陈占伟 一种用于呼吸内科的呼吸给药系统

Citations (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5119807A (en) * 1987-07-17 1992-06-09 Josephine A. Roberts Pressurized medical ventilation system
US5355872A (en) 1992-03-04 1994-10-18 Riggs John H Low flow rate nebulizer apparatus and method of nebulization
US20060283447A1 (en) * 2005-05-23 2006-12-21 Dhuper Sunil K Patient interface assemblies for use in ventilator systems to deliver medication to a patient
US20070083677A1 (en) * 2005-05-18 2007-04-12 Nektar Therapeutics Valves, devices, and methods for endobronchial therapy
US7634998B1 (en) * 2005-07-15 2009-12-22 Fenley Robert C HME shuttle system
EP2324876A2 (fr) 1996-02-13 2011-05-25 Trudell Medical Limited Nébuliseur et procédé de nébulisation
US20140053830A1 (en) * 2002-05-07 2014-02-27 The Research Foundation Of State University Of New York Methods, Devices And Formulations For Targeted Endobronchial Therapy
US20140238397A1 (en) 2011-10-01 2014-08-28 Hamilton Bonaduz Ag Ventilation Tube System
US20150108670A1 (en) 2011-08-23 2015-04-23 Armstrong Medical Limited Humidified gas delivery system
US20150224278A1 (en) 2014-02-10 2015-08-13 Pneumoflex Systems, Llc Nebulized ventilation system
US20160250437A1 (en) * 2005-08-23 2016-09-01 Nektar Therapeutics Self-sealing t-piece and valved t-piece
WO2019236896A1 (fr) 2018-06-06 2019-12-12 The Research Foundation For The State University Of New York Nébuliseur amélioré par la respiration pour l'administration de médicaments en aérosol à des patients ventilés

Family Cites Families (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3775679D1 (de) * 1986-09-22 1992-02-13 Omron Tateisi Electronics Co Vernebler.
US5322057A (en) * 1987-07-08 1994-06-21 Vortran Medical Technology, Inc. Intermittent signal actuated nebulizer synchronized to operate in the exhalation phase, and its method of use
US5388571A (en) * 1987-07-17 1995-02-14 Roberts; Josephine A. Positive-pressure ventilator system with controlled access for nebulizer component servicing
US5062419A (en) * 1991-01-07 1991-11-05 Rider Donald L Nebulizer with valved "T" assembly
US6269810B1 (en) * 1998-03-05 2001-08-07 Battelle Memorial Institute Pulmonary dosing system and method
GB2396825B (en) * 2002-11-20 2004-12-08 Profile Respiratory Systems Lt Improved inhalation method and apparatus
WO2007008825A2 (fr) * 2005-07-11 2007-01-18 Emory University Systeme et procede de liberation optimisee d'un aerosol dans les voies respiratoires
WO2010091259A2 (fr) * 2009-02-06 2010-08-12 Vapotherm, Inc. Nébuliseurs chauffés, systèmes de nébuliseur, et procédés d'inhalothérapie
EP2628445B1 (fr) * 2012-02-17 2019-01-30 General Electric Company Appareil pour l'analyse de gaz respiratoire circulant le long d'un tubage respiratoire pour la respiration d'un sujet
CA2879473C (fr) * 2014-01-23 2021-12-28 Francesco Fiorenza Systeme de pontage et procede pour l'inhalotherapie et l'anesthesie
JP2019529012A (ja) 2016-09-02 2019-10-17 インスピリックス，インコーポレーテッド 呼吸増強ジェットネブライザ
EP3787637A4 (fr) * 2018-02-07 2021-12-08 Duke University Système et procédé de phosphorylation du gpcr homogène et d'identification de modulateurs allostériques positifs des récepteurs bêta-2 adrénergique

Patent Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5119807A (en) * 1987-07-17 1992-06-09 Josephine A. Roberts Pressurized medical ventilation system
US5355872A (en) 1992-03-04 1994-10-18 Riggs John H Low flow rate nebulizer apparatus and method of nebulization
US5355872B1 (en) 1992-03-04 1998-10-20 John H Riggs Low flow rate nebulizer apparatus and method of nebulization
EP2324876A2 (fr) 1996-02-13 2011-05-25 Trudell Medical Limited Nébuliseur et procédé de nébulisation
US20140053830A1 (en) * 2002-05-07 2014-02-27 The Research Foundation Of State University Of New York Methods, Devices And Formulations For Targeted Endobronchial Therapy
US20070083677A1 (en) * 2005-05-18 2007-04-12 Nektar Therapeutics Valves, devices, and methods for endobronchial therapy
US20060283447A1 (en) * 2005-05-23 2006-12-21 Dhuper Sunil K Patient interface assemblies for use in ventilator systems to deliver medication to a patient
US7634998B1 (en) * 2005-07-15 2009-12-22 Fenley Robert C HME shuttle system
US20160250437A1 (en) * 2005-08-23 2016-09-01 Nektar Therapeutics Self-sealing t-piece and valved t-piece
US20150108670A1 (en) 2011-08-23 2015-04-23 Armstrong Medical Limited Humidified gas delivery system
US20140238397A1 (en) 2011-10-01 2014-08-28 Hamilton Bonaduz Ag Ventilation Tube System
US20150224278A1 (en) 2014-02-10 2015-08-13 Pneumoflex Systems, Llc Nebulized ventilation system
WO2019236896A1 (fr) 2018-06-06 2019-12-12 The Research Foundation For The State University Of New York Nébuliseur amélioré par la respiration pour l'administration de médicaments en aérosol à des patients ventilés

Non-Patent Citations (4)

* Cited by examiner, † Cited by third party
Title
D.D. MILLERG.C. SMALDONE ET AL.: "Aerosol Delivery and Modern Mechanical Ventilation, In Vitro/In Vivo Evaluation", AM J RESPIR CRIT CARE MED, vol. 168, 2003, pages 1205 - 1209
P. DIOTG.C. SMALDONE ET AL.: "Albuterol Delivery in a Model of Mechanical Ventilation", AM J RESPIR CRIT CARE MED, vol. 152, 1995, pages 1391 - 1394
See also references of EP3801715A4
T.G. O'RIORDANG.C. SMALDONE ET AL.: "Nebulizer Function during Mechanical Ventilation", AM REV RESPIR DIS., vol. 145, no. 5, May 1992 (1992-05-01), pages 1117 - 22, Retrieved from the Internet <URL:https://doi.org/10.1164/ajrccm/145.5.1117>

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11839716B2 (en) 2016-07-08 2023-12-12 Trudell Medical International Smart oscillating positive expiratory pressure device
US11497867B2 (en) 2016-12-09 2022-11-15 Trudell Medical International Smart nebulizer
US11666801B2 (en) 2018-01-04 2023-06-06 Trudell Medical International Smart oscillating positive expiratory pressure device
US11712175B2 (en) 2019-08-27 2023-08-01 Trudell Medical International Smart oscillating positive expiratory pressure device with feedback indicia
WO2022140800A1 (fr) * 2020-12-24 2022-06-30 The Research Foundation For The State University Of New York Circuit respiratoire de ventilateur avec un nébuliseur entre le ventilateur et l'humidificateur
US11964185B2 (en) 2023-04-24 2024-04-23 Trudell Medical International Smart oscillating positive expiratory pressure device

Also Published As

Publication number Publication date
US20210236750A1 (en) 2021-08-05
MX2020013254A (es) 2021-02-22
US20210361896A1 (en) 2021-11-25
EP3810235A1 (fr) 2021-04-28
WO2019236896A1 (fr) 2019-12-12
EP3801715A4 (fr) 2022-04-13
EP3810235B1 (fr) 2023-12-13
KR20210049719A (ko) 2021-05-06
KR20210018306A (ko) 2021-02-17
CA3102421A1 (fr) 2019-12-12
EP3801715A1 (fr) 2021-04-14
MX2020013255A (es) 2021-02-22
CA3102394A1 (fr) 2019-12-12

Similar Documents

Publication Publication Date Title
US20210236750A1 (en) Breath actuated nebulizer for ventilator circuit
US7267121B2 (en) Aerosol delivery apparatus and method for pressure-assisted breathing systems
AU2018200844B2 (en) Nebulizer mouthpiece for reducing drug loss
KR101226995B1 (ko) 압력 보조식 호흡 장치용 에어로졸 전달 장치
US8967141B2 (en) Inhalation systems, breathing apparatuses, and methods
US7493898B2 (en) Inhalation apparatus
US20200368457A1 (en) Design of aerosol system and interface to deliver clinically and economically feasible inhaled dose with neonatal cpap device
US20220305229A1 (en) Ventilator with switching valve
US20100031964A1 (en) Flow control adapter for performing spirometry and pulmonary function testing
WO2010045408A2 (fr) Administration automatisée de médicaments en aérosols pendant une anesthésie avec une ventilation synchronisée
WO2020236860A1 (fr) Circuit de ventilation mécanique à nébulisation humide
US20240075238A1 (en) Ventilator breathing circuit with a nebulizer between the ventilator and humidifier
SU1377106A1 (ru) Аппарат искусственной вентил ции легких с аэрозольной ингал цией
CN219700730U (zh) 吸气同步喷射雾化相结合的高流量氧疗设备
US20220008672A1 (en) Aerosolised medication of ventilated patients with minimised dead volume

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 19816173

Country of ref document: EP

Kind code of ref document: A1

DPE1 Request for preliminary examination filed after expiration of 19th month from priority date (pct application filed from 20040101)
ENP Entry into the national phase

Ref document number: 3102421

Country of ref document: CA

NENP Non-entry into the national phase

Ref country code: DE

ENP Entry into the national phase

Ref document number: 2019816173

Country of ref document: EP

Effective date: 20210111